In honor of National Eosinophil Awareness Week, Maria Manuel-Rubio, a nurse practitioner in our Eosinophilic Esophagitis (EoE) Program, shares her insights on this this relatively new condition, and how it has impacted one of her patients.
By Maria Manuel-Rubio, APN
Imagine a life where your child has reflux, but the symptoms do not improve. Imagine a life where your child vomits the foods that he or she eats. This is what life is like for Zachary Fincher.
Zachary was diagnosed with eosinophilic esophagitis (EoE) in 2002. EoE is an allergic inflammatory condition caused by infiltration of eosinophils (white blood cells) into the esophagus (food pipe). Eosinophils are not typically in the esophagus. The presence of eosinophils in the esophagus cause inflammation that is associated with food allergens (i.e., dairy, soy, egg and wheat) and/or environmental allergens. Symptoms of EoE include vomiting, abdominal pain, feeding aversion, dysphagia (painful or difficulty swallowing and food impaction (food gets stuck in the esophagus).
Zachary’s chronic vomiting did not improve with reflux medications. He underwent an endoscopy to determine the cause for his vomiting. An endoscopy is a medical procedure that allows the doctor to look into the esophagus, stomach and duodenum (the first part of the small intestine) with a flexible camera. Small tissues samples (biopsies) are taken from the esophagus and are looked under the microscope to assess the number of eosinophils.
After being diagnosed with EoE, Zachary’s initial treatment involved placing him on a strict elemental diet which meant he was fed with a special hypoallergenic formula that was administered by nasogastric feeding tube.
The diagnosis of EoE posed some lifelong challenges for Zach and his family. Food was never thought of as the same. Zachary has undergone multiple endoscopies over the years to determine what foods were allowable in his diet.
Despite these adversities, Zachary and his family have become advocates for patients with EoE. Zachary and his family planned an event called Zack Attack, a 5K run to raise community awareness of EoE. Zachary’s parents, Teresa and Ken Fincher are also parent mentors and have provided guidance to newly diagnosed EoE patients and families.
EoE is a newly recognized disease over the past decade that has been increasingly diagnosed in children and adults. Lurie Children’s Division of Gastroenterology, Hepatology and Nutrition has a special program for patients with eosinophilic disorders.The Eosinophilic Gastrointestinal Diseases Program offers a multidisciplinary team headed by Gastroenterologists Barry Wershil, MD, and Amir Kagalwalla, MD, along with a dedicated team which includes a pediatric allergist, a pediatric nurse practitioner, registered nurses, a registered dietitian and clinical researcher professionals.
Maria Manuel-Rubio is a pediatric nurse practitioner in Lurie Children’s Division of Gastroenterology, Hepatology and Nutrition.